The Care Quality Commission
  • Services in your home
  • Homecare service

Archived: Totalcare (Fenland) Limited

Overall: Requires improvement read more about inspection ratings

15 Upwell Road, March, Cambridgeshire, PE15 9DT (01354) 661951

Provided and run by:
Total Care (Fenland) Limited

All Inspections

28 May, 1and 2 June 2015

During a routine inspection

Totalcare (Fenland) Limited is a domiciliary care agency which is registered to provide personal care to people living in their own homes. It provides a service in March and Chatteris and the surrounding villages. At the time of this inspection care was provided to 13 people.

The last inspection took place on 28 August and 9 September 2014. We found the provider was meeting all the regulations we looked at.

This announced inspection took place on 28 May, 1 and 2 June 2015. We told the provider two days before our visit that we would be coming. We did this because the registered manager is sometimes out of the office providing direct care to people. We needed to be sure that they would be present for the inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were only employed after the provider carried out satisfactory pre-employment checks. Staff worked long hours to ensure people’s needs were met and new staff were being recruited during our inspection. Staff were well supported by managers on a day to day basis. However, there was no system in place to monitor and manage staff practice more formally. Staff had been trained to carry out their roles. However, this training was not always by someone qualified to provide the training. In addition the registered manager and staff had not received update training in key areas such as moving and handling for two years. This meant staff may not have followed up to date and current guidance when providing care.

Staff were aware of the procedures for reporting concerns and of how to protect people from harm. Although there was detailed guidance for staff to follow, risk assessments had not been carried out to help reduce the risk of harm occurring to people. Oral medicines were administered safely, but this was not the case for prescribed creams where no records were kept. This meant people may not have received their medicines in line with the prescribers instructions.

The CQC monitors the operations of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. We found people’s rights to make decisions about their care were respected. However, should the need arise to provide care to people who lacked capacity staff were not aware of their responsibilities under the MCA or DoLS.

People and their relatives were involved in the development of their care assessments and care plans. However they were not always involved in the reviewing of their care plans. Care plans did not always reflect people’s current care needs.

The registered manager and assistant manager provided direct care and had weekly contact with all the people receiving a service. People were confident any concerns they raised would be addressed. However, there were no formal systems in place for the provider to receive feedback or monitor the service provided.

People received care and support from staff who were friendly and caring. Staff treated people with respect and kindness. The service was reliable, flexible and staff always attended calls. Staff understood and met the needs of the people they cared for.

We found a number of breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

28 August and 9 September 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer the five key questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at. If you would like to see the evidence that supports the summary, please read the full report.

During our inspection we spoke with two people who received a service and two of their relatives. We also spoke with three staff members and the registered manager.

Is the service safe?

There were enough qualified, skilled and experienced staff to meet people's needs. We saw that staff had undertaken training in topics relevant to their work. People's care records showed that risks associated with providing care were identified and assessed. This ensured care was provided safely.

Is the service effective?

Care was planned and delivered in a way that ensured people's safety and welfare. People, and their relatives, made very positive comments about the service they received. People told us that they were 'very happy' with the service, that the staff were caring and reliable. People told us that they felt the care workers met their care needs.

People's health, safety and welfare was protected when more than one provider was involved in their care because the staff worked in co-operation with others.

People said that their care was provided by as few care workers as possible. This helped to maintain the consistency of their care provided. People said that they, or their family members using the service, developed good relationships with staff members. One person's relative said that the care workers understood that their family member liked to 'laugh and joke' and responded to this 'like they had known them all their life.' They said they felt confident that the care workers provided good care to their family member.

Is the service caring?

People told us that the staff that provided the service to them were caring and understood their needs. They said that the staff were reliable and listened to them. They said they felt staff respected their views and were mindful of their, or their family member's, feelings when providing personal care.

Is the service responsive?

The provider had an effective system to assess and monitor the quality of service that people received. This included care reviews and 'spot checks' of the care provided to people. Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

Is the service well-led?

A registered manager was in post at the service and had been for several years. The manager or deputy manager visited most people weekly. The feedback they received during these visits enabled them to quickly identify and address any issues that were raised. People told us that they were confident any concerns they raised would be addressed. Care workers told us they felt supported by senior staff and had received training in relevant topics.

We found that the provider was fully compliant with the five areas we assessed. If you wish to see the evidence supporting our summary please read the full report.

24 September 2013

During a routine inspection

People that we spoke with were positive about the care and support they received and one person commented that: 'The carers are kind and cheerful'. People told us that they were able to discuss changes to their care and support and that their views were always taken into account. The care plans we saw showed peoples' preferences regarding how they would like their care and support to be delivered.

There were procedures in place to ensure that medicines were administered safely and recorded. Staff received medication training and undertook competency tests to ensure their safe practice.

There were recruitment procedures in place to ensure that appropriate checks had been made prior to staff starting work. Staff completed an induction programme and mandatory training was provided to ensure they were competent to deliver care.

The agency had a procedure in place to deal with concerns and complaints that were raised by people using the service. People we spoke with using the service told us that they had access to the office staff to resolve any concerns or queries that they may have.

27 June 2012

During a themed inspection looking at Domiciliary Care Services

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service'.

We used postal surveys, telephone interviews and home visits to people who use the service and to their main carers (relatives or friends) to gain views about the service.

We visited four people in their homes who told us that they were very satisfied with the care and support they received from the agency. We also spoke with four carers and to relatives of people using the service.

We talked on the phone to 20 people who were positive and complimentary about the quality of the care and support they received. People told us that they felt respected and that they were treated with dignity at all times. All people told us that carers called them by their preferred name and care plan documentation kept in people's homes showed this to be the case. .

All people spoken with knew were aware of their care plans and the daily notes made by carers after each visit. Relatives that we spoke with told us that they had been involved in reviews of care where appropriate.

People we spoke with told us that they felt safe and protected from harm and that they could raise any concerns or issues which they felt would be appropriately dealt with by the manager and senior staff of the agency. People we spoke with confirmed that visits to check the quality of care and support were regularly made and that they were asked about the quality of service.